Access & Reimbursement Manager – Immunology

This is a fully remote position, open to applicants in California.

📋 Description

• Engage with designated accounts to enhance patient access within their therapeutic area product(s) by delivering proactive in-person education on product-specific programs to healthcare providers and staff, facilitating the integration of these programs into office processes and workflows.

• Demonstrate the ability to assess challenges and propose effective solutions.

• Comprehend the intricacies and address inquiries related to payer policies (e.g., utilization management, denials, and appeals), drug acquisition, inventory management, and patient/practice reimbursement (e.g., Co-pay, administration, drug claims).

• Evaluate account reimbursement challenges and opportunities as required.

• Identify trends at local, regional, and national levels, collaborating purposefully both internally and externally to support patient pull-through initiatives.

• Collaborate with the Patient Support Center (hub) on critical issues linked to patient case management, including tracking cases, resolving issues, providing reimbursement support, and educating appropriate office staff.

• Review patient-specific information in scenarios where assistance has been explicitly requested by the site and patient health information is accessible to resolve any issues or coverage challenges.

• Work in partnership with aligned cross-functional associates within NPC (as mentioned above) to exchange insights on customer requirements and barriers pertaining to access and reimbursement for their respective therapeutic area product(s).

• Uphold a profound understanding of NPC policies and requirements, executing all responsibilities with integrity and in alignment with company guidance and prescribed Values and Behaviors.

• Handle Patient Identifiable Information (PII) responsibly, ensuring compliance with HIPAA and other privacy laws and regulations, as well as internal Company compliance guidelines.

⛳️ Requirements

• A minimum of three to five years of experience in either the public or private third-party Reimbursement sector, or within the pharmaceutical industry focusing on managed care, clinical support, or sales.

• Experience with specialty pharmacy products obtained through Specialty Pharmacy networks or specialty distributors (buy and bill).

• Familiarity with coding, billing, and office support programs.

• Previous account management experience or experience with complex accounts (Payer landscape, high patient volume, large systems).

• Knowledge of Managed Care, Government, and Federal payer sectors, along with Integrated Delivery Network/Integrated Health Systems.

• Ability to function effectively as a “team player” while collaborating with multiple sales representatives, sales leadership, and internal colleagues to achieve common objectives.

• Candidates must reside within the territory or within a reasonable daily commuting distance of 60 miles from the territory border. A willingness to travel 60-80% across a wide geography is essential, with a capacity to drive and/or fly within the territory. A valid driver’s license is required.

🏝️ Benefits

• Health, life, and disability benefits

• 401(k) plan with company contribution and matching

• Generous time off package including vacation, personal days, holidays, and other leaves